| Entity Name: | OMNI PAIN CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Dec 2021 (3 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 20 Dec 2021 (3 years ago) |
| Document Number: | L21000530795 |
| FEI/EIN Number | 81-3328057 |
| Address: | 3140 S. FALKENBURG RD STE 205, RIVERVIEW, FL, 33578-2594, US |
| Mail Address: | 3140 S. FALKENBURG RD STE 205, RIVERVIEW, FL, 33578-2594, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962955765 | 2016-07-27 | 2022-01-31 | 3140 S FALKENBURG RD, SUITE 205, RIVERVIEW, FL, 335782574, US | 3140 S FALKENBURG RD, SUITE 205, RIVERVIEW, FL, 335782574, US | |||||||||||||||||||
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| Phone | +1 813-533-5522 |
| Fax | 8135335511 |
Authorized person
| Name | DR. SIDHARTH PANCHAMIA |
| Role | PRESIDENT/MANAGER |
| Phone | 8135335522 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME106682 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| YONGE L.TYLER | Agent | 6987 E FOWLER AVE, TAMPA, FL, 33617 |
| Name | Role | Address |
|---|---|---|
| PANCHAMIA SIDHARTH | Manager | 914 ANCHORAGE RD, TAMPA, FL, 33602 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000003554 | OMNI SPINE & JOINT - RIVERVIEW | ACTIVE | 2022-01-10 | 2027-12-31 | No data | 3140 S. FALKENBURG ROAD SUITE 205, RIVERVIEW, FL, 33578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-01-18 | 3140 S. FALKENBURG RD STE 205, RIVERVIEW, FL 33578-2594 | No data |
| CONVERSION | 2021-12-20 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P16000060867. CONVERSION NUMBER 700000221537 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| AMENDED ANNUAL REPORT | 2023-11-08 |
| ANNUAL REPORT | 2023-03-25 |
| Florida Limited Liability | 2021-12-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
